Background: The sudden jolt of becoming an amputee brings with it the realization of loss of independence and self-built psychological and physical security. Advances in the field of prosthesis give the individual hope for better future, but the presence of psychological morbidity is a hurdle to be crossed in the road to satisfactory rehabilitation. Aim: This study aimed to assess the psychiatric morbidity in amputees and the response to treatment. Materials and Methods: One hundred newly amputated soldiers were assessed by means of clinical interview, General Health Questionnaire, Impact of Event Scale, Hospital Anxiety Depression Scale, McGill Pain Questionnaire, and Dallas Pain Questionnaire. Individuals were treated with appropriate medications and psychotherapy, and response to treatment was assessed. Results: Psychiatric disorders were diagnosed in 66% including adjustment disorders (40%), depressive episode (20%), and posttraumatic stress disorder (6%). Phantom sensation and phantom pain were noted in 72% and 64% of participants, respectively. More psychiatric disorders and phantom sensation were found in the early months after amputation. Psychiatric morbidity was associated with negative body image, distressing pain, and restriction of activities of daily life. Treatment produced complete remission of symptoms in 65.15% of individuals suffering from psychiatric disorders and statistically significant reduction in the scores of psychiatric rating scales. Conclusions: There is a high prevalence of psychiatric morbidity among amputees. Psychiatric treatment produces significant improvement in the psychological well-being of amputees and underlines the need to focus on the psychological rehabilitations of the amputee apart from physical rehabilitation.
Background:Rheumatic mitral stenosis (MS) is a significant cause of morbidity and mortality in India. Percutaneous transvenous mitral commissurotomy (PTMC) has become the procedure of choice for severe MS with pliable leaflets. Despite a wealth of literature on the technical aspects of PTMC, there is a dearth of literature addressing the impact of PTMC on the quality of life (QOL).Aim:The aim of the study is to assess the impact of PTMC on clinical status and QOL of patients with severe MS.Materials and Methods:Twenty-five consecutive patients with severe MS undergoing PTMC were included in the study with their informed consent. All patients were subjected to routine blood tests, electrocardiogram, chest X-ray, two-dimensional and color echocardiography, treadmill test (TMT), and World Health Organization (WHO) QOL scale. The echocardiography, TMT, and WHOQOL scale were repeated after the procedure.Results:The procedural success was 98%. The mean (range) mitral valve area preprocedure was 0.82 (0.59–0.92) cm2 and postprocedure was 1.61 (1.51–1.76) cm2. The difference was statistically significant (t = 5.02; P < 0.01). The mean (range) of TMT preprocedure was 4.05 (3.0–7.0) METS and postprocedure was 8.52 (6–12) METS. The difference was statistically significant (T = 3.08; P < 0.01). The mean (range) of QOL assessment pre- and post-procedure on physical domain was 8.83 (8.3–10.1) which increased to 11.11 (10–12.7); on social relationship domain from 9.17 (7.5–12.4) to 11.37 (9.4–12.0); on personal relationship from 11.6 (11–13) to 12.52 (12–13); on environment domain from 10.78 (10.2–11.7) to 11.56 (10.8–12); and on level of independence from 9.02 (8–10) to 12.29 (11.0–13.6). All the differences were statistically significant (Wilcoxon signed-rank test z = −4.376; −4.379; −4.234; −4.200; −4.375; respectively, all P < 0.001 highly significant).Conclusions:PTMC resulted in a significant improvement in the QOL of patients with severe MS. The significant improvement in QOL post-PTMC may be an indication for offering PTMC at an earlier stage to those patients whose QOL is severely compromised.
Background:Schizophrenia is a devastating and chronic mental illness. Considering the nature of illness along with routine psychiatric care, various supportive therapies are recommended. Family psychoeducational approach has been developed to increase patients' as well as their caregivers' knowledge and insight into their illness. It is postulated that this increased knowledge and insight will enable people with schizophrenia and their caregivers to cope in a more effective way with the consequences of their illness, thereby improving prognosis.Aim:The aim of this study is to assess the efficacy of family psychoeducation intervention on the caregivers of schizophrenia patients with respect to their perceived quality of life.Materials and Methods:A total of 30 caregivers of male schizophrenia patients were selected through purposive sampling technique. Patients were divided into two groups, namely, experimental and control group. Family psychoeducation intervention was given on twice-monthly basis for 6 months to the experimental group caregivers. Baseline assessment was carried out with the help of WHO Quality of Life-BREF followed by intervention and then posttherapeutic assessment was done with same tool.Results:Most of the caregivers were above 40 years of age group, married, and male. Following family psychoeducation, significant improvement in overall quality of life scores was observed in experimental group caregivers compared to control group caregivers where no such intervention was provided.Conclusion:Family psychoeducation is feasible and useful in our clinical population.
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